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Can the Northwick Park Care Needs Assessment be used to estimate nursing staff requirements in an inpatient rehabilitation setting?

Regional Rehabilitation Unit, Northwick Park Hospital

Ruth Harris

Faculty of Health and Social Care Sciences, Kingston University and St. George's University of London

Lynne Turner-Stokes

Regional Rehabilitation Unit, Northwick Park Hospital and Department of Palliative Care, Policy and Rehabilitation, King's College London School of Medicine, UK, lynne.turner-stokes{at}dial.pipex.com

Aim : To determine whether the Northwick Park Care Needs Assessment (NPCNA) could be used to estimate nursing staff requirements in an inpatient rehabilitation setting.

Design : Retrospective analysis of NPCNA data in comparison with nursing staff provision over a six-month period from 1 April 2003 to 30 September 2003. Setting : A specialist neurorehabilitation unit.

Methods : Daily care requirements for the ward were calculated at two-week intervals by summing the NPCNA care-hour estimates for all inpatients. Nursing staff hours provided were identified from the unit's duty rota and agency records for each corresponding period.

Results : In total, 271 care-hour recordings were extracted from 59 patients. There was a poor relationship between the calculated total ward care-hour requirements and nursing staff hours provided (Pearson's r = 0.31, P = 0.29); but staff hours provided fell significantly short of estimated daily care requirements (mean shortfall 6.2 hours/day, SD 8.6 (95% confidence interval (CI) 0.73, 11.1), P = 0.03)). The shortfall was most obvious during peak care periods in the morning and at bedtime, which resonates with experience reported by nursing staff that they are overstretched at these times. A marked discrepancy between qualified nursing staff hours provided and NPCNA-estimated `special nursing' care requirements highlights a failure to address important facets of the rehabilitation nursing role.

Conclusions : The NPCNA, which was designed to assess only direct care needs in a community setting, requires the further development of a new algorithm before it could be used to estimate nursing staff requirements in a rehabilitation ward setting.

Clinical Rehabilitation, Vol. 21, No. 6, 535-544 (2007)
DOI: 10.1177/0269215507075501


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